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Prognosis of non-Hodgkin lymphoma

Survival of non-Hodgkin`s lymphoma (NHL) has not improved similarly to Hodgkin's lymphoma. Survival is somewhat better for women than for men (60% compared to 55% are alive after 5 years) and depends greatly on stage, histology, and age. There has, however,  been a positive tendency for most subgroups.

Prognostic factors for aggressive non-Hodgkin lymphomas

The International prognostic index (IPI) for aggressive non-Hodgkin lymphomas is based on studies from an international collaboration among centers in multiple countries to find reliable prognostic factors. 

Five independent negative prognostic factors have been confirmed:

  • Age > 60 år
  • Elevated LDH 
  • > 1 extranodal involvement
  • WHO performance status 2–4
  • Stage III/IV

Depending on the number of risk factors (0–5), the model separates patients into 4 risk categories with significant differences in prognoses (0–1, 2, 3, 4–5).

For ages < 60 years, an age-adjusted IPI is used where the following 3 factors have an independent negative prognostic value:

  • elevated LDH
  • WHO performance status 2–4
  • Stage III/IV

It is important to note that 5 year survival is not synonymous with cured indolent lymphomas; the survival curve continues to drop with time. However, some improvement in survival is still expected in coming years.  

Median survival for indolent lymphomas is 9 years, while for aggressive lymphomas the median survival is 4 years.

 

 

Five-year relative survival for patients with Non-Hodgkin`s lymphoma, in percent, during the diagnosis period 1974–2013.

Source: Cancer Registry of Norway

 

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